Plné znění - 241/2006 Sb.

Xxxxxxxxxxxxx xxx xxx Assessment xx Xxxxxxxxxxxx for xxx Xxxxxxxxx of Xxxxxxxxx Support xx Xxxxxxx xx Xxxxxxxx Xxxx pursuant to Xxx Xx. 209/1997 Xxxx., xx xxx xxxxxxxxx of xxxxxxxxx xxxxxxx xx the xxxxxxx xx criminal xxxx xxx xx xxxxxxxx certain xxxxx xxxx, xx xxxxxxx

Xxxx Xxx/Xxxxx,

Xx xxxxxxxxx for xxxxxxxxx you with xxxxxxxx xxxxxxxxx xx xxxx xxxxxxx xxxxxxxxx. Xxxxxxx, filling in xxxx xxxxxxxxxxxxx xx xxxxxxxx xxx xxx xxxxx xxxxxxxxxx of xxxx xxxxxxxxxxx xxx xxx provision xx xxxxxxxxx xxxxxxx pursuant xx Xxx xx. 209/1997. Thank xxx xxx xxxx cooperation; xx xx xxxxxx xxxxxxxxxxx.

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X. Xxxxxx legibly xxxx xx xxx xxxxxxxx xxxx xx xxx applicant - x.x. xxx xxxxxx xx xxx criminal xxx xxx has xxxxxxxx xxxxxx xxxx, xx xxx survivor xx x xxxxxx xxx xxx xxxx xx xxxxxxxxxxx of xxx xxxxxxxx xxx:

1. Xxxxxxx:

2. Given xxxx:

3. Xxxx xx xxxxx:

4. Xxxxxxxxx address:

5. Mail xxxxxxxx xxxxxxx (xxxxxx xx xxxxxx xxxx xxx xxxxxxxxx xxxxxxx, xxxx):

6. Phone Xxxxxx:

7. X-xxxx xxxxxxx:

8. Nationality:

II. Xx the applicant xx represented xx xxxxxxx xxxxxx ("xxxxxxxxxxxxxx") xx xxx xxxxx xx xxxxxxxxx representation (xxx instance, x xxxxx child xxxxxxxxxxx xx xxx/xxx xxxxxx) xx xx xxx xxxxx of a xxxxx xx xxxxxxxx, xxxxxx xxxx xx xxx data of xxxx representative:

1. Surname:

2. Xxxxx name:

3. Xxxxxxxxx xx xxxxxxxxxx xxxxxxx:

Xx xxx xxxxxxxxxxxxxx xx xxxxxx the xxxxxxxxxxx xx xxxxxx xx xxx applicant, xxxxxx xxxx xxxxxx x xxxxxxxx authorizing xxx/xxx xx xxxxxxxxx xxx xxxxxxxxx - a xxxx of a xxxxx xx attorney (xxx xxxxxxxxxxx xxxxxxxxxxxxxx) xx x copy xx xxx birth xxxxxxxxxxx (for statutory xxxxxxxxxxxxxx) or xxx xxxxx xxxxxxxxxx document.

III. Xx the xxxxxxxxx xx x xxxxxxxx xx x person xxx has xxxx xx consequenee xx xxx xxxxxxxxxx criminal xxx, please xxxx xx xxx personal xxxx xx xxx xxxxxxxx:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Xxxx xx xxxxx:

4. Date xx xxxxx:

5. Xxxx xxxxxxxxx xxxxxxx:

6. Xxxxxxxxxxx:

7. Xxxxxxxxxxxx xx the xxxxxxxx xx xxx xxxxxxxxx (x.x. father, xxxxxxxx, xx xxxxxxxxxx xxxxxx xx xxxxxx xxxxxxxxx)

Xx xxx xxxxxxxxx xx x xxxxxxxx of x xxxxxx xxx xxxx in consequence xx the xxxxxxxx xxx, please xxxxxx x xxxx of xxx death xxxxxxxxxxx xxx any xxxxxxxxx xxxxxxx that the xxxxxxxx xxxxxxxxx xx xxx an obligation xx support xxx xxxxxxxx (xx xxx xxxx of x xxxxxx-xxxxx xxxxxxxxxxxx, such xxxxxxxxx xxxxxxx birth xxxxxxxxxxxx or a xxxxx xxxxxxxx on xxx xxxxxxxxxx xx xxxxxxx the xxxxxxxxx; xx xxx xxxx xx married xxxxxxx, xxxxxx xxxxxx x xxxxxxxx xxxxxxxxxxx).

Xxxxxx xxxxxxx the xxxx on which xxx xxxxx xxx xxxxxxxxx xxx, xx xxx victim xxxxxxx xxxxx xxx consequences xx xxx xxxxx xx x xxxxx xxxx, xxxxxx xxxx xxxxxxx xxx xxxx xxx xxx manner xx which xxx xxxxxx xxxxxxx of xxxx consequences (x.x., xxx xxxx xx xxx xxxxxxx xxxxxx).

XX. Xxxxxx xxxxxxx the xxxxxxxx xxxxxxx xxxxxxxxx (x.x. xxxxxx, xxxxxx xxxxxxxxxx'x xxxxxx, xxxxx) xxxxx xxxx xxxxxxxx xxxxxxxxx xxxxxxxx xxxxxxxxxxx. Xxxxx xxx xxxxxxxxx xxxxxx of xxx xxxx xxxxxxx to xxx respective proceedings.

If xxxxxxxxx, xxxxxx xxxxxx xxx xxxxxx xxxxxxxx xx xxx xxxxxxxxxxxxxx xxxxxxxx xxxxxxx xxxxxxxxx xxxxx xxxxx xxxxxxxx xxx xxxxx xx xxx xxxxxxxxxx proceedings (x.x. resolution xx xxx xxxxxxxxxxxxxxx of xxxxxxxx xxxxxxxxxxx, xxxx xx the indictment, xxxxxxxxx - xxxxx xx xxxxxxxxx).

According xx the provisions xx §8 xx Xxx xx. 209/1997, xxx amount xx xxxxxxxxx support xxx xx reduced or xxxxxxxx xxxxxxxxx on xxxxxxx xxx victim xxx made xxx xx all legal xxxxxxxx xx enforce x xxxxx for xxxxxxxxxxxx xxxxxxx xxx xxxxxxxx or xxx xxxxx xxxxxx xxxxxxxxxxx xxx xxx xxxx xxxxxxxx. Xx xxx xxxx in xxxx xxxx xx xxx xxxxxxxx xxx xxx xxxx xxxxxxxxxx.

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Xxxx xx xxxx XxXx xx xxx applicant is x xxxxxxxx xx xx xxxxxxxxxx who xxx died xx xxxxxxxxxxx of the xxxxxxxxx xxxxx.

1. Xxx you x xxxxx, xxxxxx or xxxxx xx xxx xxxxxx xxx xxxx xx xxxxxxxxxxx xx xxx criminal xxxxxxx?

2. Xxx xxx xxxx xx a xxxxxx xxxxxxxxx with the xxxxxxxx xxxxxx xxxxx xx the xxxxxxxxxx xx xxx xxxxx?

3. Xxxx you x xxxxxxxxx xx xxx xxxxxx xx xxx xxx xxxxxxxx xxxxxxx xx xxxxxxx xxx?

4. Xx any xxxxx xxxxxxx xxxx the xxxxxxxxxx described xx xxxxxxx 1 xx 3? Xxxxxx xxxx xxxxx xxxxxx, xx xxxxx xx xxx.

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Xxxxxxxxx xx xxx xxxxxxxxxx xx §2, xxxxxxx 2 xx Act xx. 209/1997, a xxxxxx xxx xx x xxxxxxxx xx x xxxxxx who xxxx xx consequence xx a xxxxxxxx xxx is xxxxxxxxxx xx xx x xxxxxx xx xx xx xxx xx x xxxxxx, xxxxxx xx xxxxx of xxx xxxxxxxx and xxxxx xxxx him xx her in xxx same xxxxxxxxx xx xx xxx xxxxxx was a xxxxxxxxx of the xxxxxxxx xx the xxxxxxxx xxx xxxxxxxx xx xxxxxxx xxx xxxxxx.

Xx xxx applicant xx the xxxxxx xx x xxxxx xxx xxx xxxxxxxx xxxxxx xxxx, xxxxxx xxxx xx items XX - XIV.

Please xxxxxx x point-based xxxxxxxxxx xx xxxx xxx xxxxxxxxx pursuant to Xxxxxx No. 440/2001 Xxxx. The respective xxxxxxxx xxxxxx xx xxxxxxxx xxxx xxx xxxxxxxxx responsible for xxx xxxxxx'x xxxxxxxxx. Xxxx xxxxxxx xxxxxx xxxx contain a xxxxx-xxxxx assessment xx xxx pam xxxxxxxx xxx x point-based xxxxxxxxxx of xxx xxxxxxxx xx xxx xxxxxx'x xxxxxx xxxxxxxx. Xxxxxx xxxx xx xxxx xxxx only xxx xxxxx-xxxxx assessment xx the pam xxxxxxxx is xxxxxxxx xxx xxx xxxxxxxx xx Xxx no. 209/1997. According to xxx xxxxxxxxxx of §6, section 2 xx Act xx. 209/1997, xx xxxxxxxxx xxxxxxx xxxx xx xxxxxxxx xxxxxx xxx xxxxx xxxxxxxxxx xx xxx xxxx xxxxxxxx xx xx xxxxx 100 xxxxxx.

Xxx xxxxxx xxx xxxxxx xxxx xxx financial xxxxxxx xx xxx xxxxxx of XXX 25,000 or an xxxxxx xxxxx xx xxx xxxxxx costs xx xxxxxxx xxxxxxxxx xxx xxxx xxxxxx (§7, xxxxxxx 1, xxxxxx x of Xxx No. 209/1997 Xxxx.). lf xxx xxxxxx to apply xxx a lump xxx payment, there xx xx need xx xxxx xx xxxxx XXX - XxX.

Xxxx includes xxx xxxxxxxx for xxxxxxxxxx, xxxxxxxx xxxxxxxxx, xxxxxxxxxxxxxx xxxxx, xxxxxx xx xxxxxxxxx to xxxx xxx xx xxx home or xxxx xxxxxxx treatment, xxxxxxxxx xxxxxxxxxxxxxx xxxxx xxx., xxxxxxxx xxxx xxxxx xxxx xxx xxxx xxxx xx xx insurance xxxxxxx. xx such xxxxxxxx xxx xxx proved xx xxxxxxxxxxx xxxxxxxx, xxx Xxxxxxxx of Xxxxxxx xxx xxx xxxx xxxx xxxx xxxxxxxxxxxxx.

Xxxxxx xxxxxx xxx xxxxxxxxx xxxxxxxxxx xxxx facts xx xxx xxxxxxxxxxx.

Xx xxx xxxxxxxxx is an xxxxxxxx, xxxxx xxxxxxxxx xxxxx xxxxxxx a xxxxxxxxx from his/her xxxxxxxx describing the xxxxxxx salary according xx §351 xx. xxx. xx Act xx. 262/2006, the Xxxxx Xxxxxx Xxxx, xx xxxxxxx. xx xxx applicant xx xxxx-xxxxxxxx, xxxx document xxxxx be x xxxx of xxx/xxx xxxx recent xxx xxxxxx. xx the xxxxxxxxx xx a xxxxxxx xxxxxx xxx xx able xx xxxxx xxx/xxx impaired xxxxxx xxxxxxxx, please xxxxxx x xxxxxxxx xxxxxxxxxx xxx xxxxxx xx xxx retirement xxxxxxx. xx for xxx reason xxx xxxxxxxxx'x income xxxxxxxxx xxxxxx xx xxxxxx, xx xxxxxxxxxxx xxxxx xx affidavit xxx xx attached.

Xx xxxxxx xxxxxxxx has xxxx impaired xx x xxxxxx xx xxx criminal xxx xx xxxxx X xxx a xxxxxx. X have xxx xxx xxxx compensated xxx xxx xxxx 1 xxxx xxxxxxxx xx x xxxxxx xx the xxxxxxxx xxx.

X xxxxxx affirm xxxx X have xxx lodged any xxxxx xxx financial xxxxxxx or xxx xxxxxxx xxxxx for xxxxxxxxxxxx for xxx xxxx xxxxxxxx as x xxxxxx of xxx criminal act xx xxx country xxxxx than xxx Xxxxx Republic.

I xxxxxxxxxxx xxxx xxxxxxxxx to §12 xx Act Xx. 209/1997 Xxxx., xx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxx xxx victims xx xxxxxxxx xxxx xxx xx xxxxxxxx xxxxxxx other xxxx, xx xxxxxxx, X xx xxxxxxx to xxxxxxxxx xxx Xxxxxxxx xx Xxxxxxx xxx xxxxxx received as xxxxxxxxxxxx xxx xxx xxxx xxxxxxxx, xx xx xxx xxxxxx xx the xxxxxxxxx xxxxxxx, within xxxx xxxxx from xxx xxxx xx receiving xxx xxxxxxx xxxxxxx. X xxxx acknowledge xxxx, xxxxx the xxxxx xx the xxxx-xxxx xxxxxx, X xxx xxxx xx xxxxxxxxxxx xxxxxx xxx Xxxxxxxx xx Justice xx xxxxx the xxxxx'x xxxxx for xxx xxxxxx xx xxx xxxxxxxx xxxxxxx, xxxxxx such a xxxxxx xx xxxx xxxxxxxx xx xx xxxxxx xxxxxxxx, the xxxxx xxxxxx of xxxx suffered xxx xxx xxxxxx xx xxxxxxxxxxxx xxxxxxxx.

X xxxx xxxxxxxxxxx xxxx xxxxxxxxxxx xxxxxx false xx xxxxxxxxxx information xx xxxxxxxxxxx xxxxxxxxxxx xxx xxx purposes of xxxxxxxxxxxxx xxxxxxx benefits xxx xxxxxxxxx xx xxxxxxx pursuant xx §21, xxxxxxx 1, xxxxxx x) xx Xxx no. 200/1990 Xxxx., xx xxxxxxxx xx xxxxxxx.

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Xxxxxxxxx of xxx xxxxxxxxx xx xxx/xxx xxxxxxxxxxxxxx

- Xxxx xxxxxxx of xxx xxxxxxxxxxx xxx the xxxxxxxxx xx xxxxxxxxx xxxxxxx xxxxxxxx xx Xxx Xx. 209/1997, xxx Xxxxxxxx xx Xxxxxxx shall confirm xxxxxxx and xxxxxx xx a xxxxxx xxxxxx. Subsequently, the Xxxxxxxx xxxxx initiate xx investigation with xxx police or x similar xxxxxxxxx xx per the xxxxxxxx details xx xxx xxxx. Within xxxxx xxxxxx xxxx xxx xxxx xx xxx xxxxxxx xx xxx application and xxxxxxxxxx xx xxx xxxxxxxxx documents, xxx Xxxxxxxx xxxxx xxxxxx xxxxxxx xxx xxxxxxx xx xxxxxx xxx xxxxxxxxx of xxx xxxxxxx why xxxx xxxxxxx has xxxx xxxxxxxx.

- Xxx xxxxxxxxx xxxxx xx xxxxxxxxxx x xxxxxx xx xxx Xxx Xx. 209/1997 Xxxx. only xx xx/xxx xxx xxxxxxxx xxxxxx harm xx x result xx xxx xxxxxxxxxx xx x xxxxx. X xxxxxxxxx xxx xxx xxx xxxx xxxxxxxxx xxx xxx xxxxxx'x xxxxxxx xx xxxxxxxx xxxxxxx xxxxx xx the xxxxxx xx xxx point-based xxxxxxxxxx xx xxx xxx xxxxxxxx (xxx xxx weakening xx xxxxxx xxxxxxxx), xxxxx xxxx xx at xxxxx 100 points. Xxxxxxxxx xx x xxxxxx xxx xxx xxxx xx consequence xx x xxxxx xxxxx be xxxxxxxxxx xx xx a xxxxxx xx xxx xxxxxxxx xx a xxxxxx, xxxxxx xx xxxxx of the xxxxxxxx and xxx xxxxxxxx xxxxxx x xxxxxxxxx with xxx xxxxxxxx at xxx xxxx xx xxx/xxx xxxxx xx xx xxx xxxxxxxx xxxxxxxxx xx xxx required xx xxxxxxx the xxxxxxxx.

- Xxx Xx. 209/1997 Coll. xx xxx provision xx xxxxxxxxx xxxxxxx xx xxxxxxx xx xxxxxxxx xxxx xxxxxxxxxx x xxxxxxxxxx xxxx of 1 year from xxx date xx xxxxx the xxxxxx xxxxxxx of xxx xxxx xxxxxx xx xxx xxxxx. Xx xxxx xxxx xxxx xxx xxxxxxxx xxxx xxx xxxx of xxx commitment xx xxx xxxxx, xxx xxxxxx shall provide xxxxxxxx xx xxx xxxx on xxxxx xx/xxx learned of xxx xxxxxxxxxxxx. Xxx Xxxxxxxx xx Justice xxxxxx xxxx xx xxxxxxxxxxx for xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx received xxxxxxx xxxxx xxx lapse xx the xxxxxxxxxxxxxx xxxxxx.

- Xxxxxxxxx support xx applied for xx x victim xxx xxx xxxxxxxx xxxxxx xxxx xx x xxxxxx xx xxx xxxxxxxxxx of x crime may xx xx xxx xxxx xx x xxxx xxx xxxxxxxxx xx XXX 25,000 xx xx xxxxxx xxxxx xx xxxx xxxxxx or the xxxxx of xxxxxxx xxxxxxxxx as proved xx xxx xxxxxx, xxxxxxx xx any xxxxxx previously xxxx xx xxx xxxxxx xx xxxxxxxxxxxx xxx xxx harm xxxxxxxx. Xxx xxxxx xxxxxx xx such xxxxxxx xxxx xxx exceed XXX 150,000. If, xxxxx the xxxxxxxxx xx xxxxxxx, xxx xxxxxx xxxxxx xxxx xxx xxxx suffered xxxxxxx xxx xxxxxx xxxxxxxx, xxx victim xxx xxxxxxx xxxxxxxxxx xxxxxxx up to xxx amount xx XXX 150,000 if xx/xxx xxxxxxx xxx xx within xxx xxxxxxxxxxxxxx xxxxxx of xxxx (x.x., 1 xxxx xxxx xxx xxxx xx xxxxx xxx victim xxxxxxx xx the xxxx xxxxxx by xxx xxxxx); xx xxxx xxxx, xxx xxxxxxx xxxxxxx paid xxxx xx xxxxx xxxx xxxxxxx.

- Xx xxxxxxxxxx xxx xx x xxxxxxxx xx x xxxxxx who xxx xxxx as a xxxxxx xx xxx xxxxxxxxxx xx x xxxxx (x xxxxxx, xxxxxx xx xxxxx xx xxx xxxxxxxx xxxxxx xx a xxxxxx xxxxxxxxx xxxx xxx xxxxxxxx at xxx xxxx xx xxx/xxx death xx xxxxxxxxx xx xx xxxxxxxx xx xx xxxxxxxxx xx the xxxxxxxx) shall be xxxxxxxx xxxx x xxxx xxx xxxxxxxxx xx XXX 150,000. Xxx xxxxx xxxxxx xxxxxxxx xx xxxxxxxxx xxxxxxx shall xxx xxxxxx XXX 450,000; xxxxxx xxx xxxxxx xx victims xxxxxx xxxxx, xxx xxxxxx xxxxxxxx xxx xxxxxx xxxxx xx xxxxxxx xxxxxxxxxxx.

- Act No. 209/1997 Coll. does xxx xxxxxxx xxx xxxxxxxxx xx xxx xxxxxxxxx liability xx xxxxxxxxx of xxxxx xxxxxxxx xxxxxxx xx xxxxxxxxxx liability xxxxxxxxx. Xx xxxxxxx xxxxxxx xx xxxxxxx xxxxxxxxx, xxxxxxxxxxxx xxx xxxxxxxxx xxxxxxxx should xxxx xx directed xx xxx insurers providing xxxx xxxxxxxxx insurance. Xxxx xx xxxxxxxx xxxxx, xx xxxx xx xxxxxxxxxxx xxxxxxxxxxxxx, xxx xx xxxxxxxxxxx xxx xxx provision xx financial support xx filed with xxx Xxxxxxxx xx Xxxxxxx.

- Please xxxx xx xxxx xxxx xxx xxxxxxxxx documents xxx xxxxxxxxxxxxx xxxxxxxx xxx the xxxxxxxxxx xxxxx must xx xxxxxxxx xx the xxxxxxxxxxx. Xx xxx xxxxxxxxx xxxxx xx xx xx, xxx Xxxxxxxx xx Justice xxxxxx xxxxxxxx process xxx application. Xxxxxx xxx xxxxxxxxx fail xx xxxxxxx xxx xxxx xxxxxxxxx xxx xxxxxxxxxxxxx xxxx xxxxxx x xxxxxxxxxxxxx xxxxxxxx, xxxx xxxx xxx xxxxxxx x xxxxxxxx xx xxxxxxxx xxx xxxxxxx as per Xxx Xx. 209/1997 Xxxx. Xxxx xxxxx xxx, xxxxxxx, xxxxxxxxx xxx xxxxxx of xxxxxxx application.

- Xxxxxx xxxx in xxxx xxxx xxx xxxxxxxxx xxxxx be xxxxxxx xx xxxxxx xxx xxxxxxxxx xxxxxx xxxxxxxx xx xxxxxxxxxxxx xxx xxxx (xxxx xxx xxxxxxxx, insurers xxx.) xx the xxxxxxx xx xxx Xxxxxxxx xx Justice xx xx xxx xxxxxx xx the support xxxxxxxx. This xxxxxxxxxx xxxx xxx xxxxx xx xx/xxx xxx xxx received xxx xxxxxxxxxxxx. Xx xx xxxxxxxxx by xxx xxxxxx xx xx xxxxxxxxxxx, xxx Ministry xx Xxxxxxx xxx xxxxx xxx state's xxxxx to claim xxx xxxxxx of xxx xxxxxxxxx xxxxxxx xxxxxxxx xxxxx xxx xxxxx of xxx xxxx-xxxx xxxx, xxxxxxxx xxxx x waiver xx xxxxxxxxx xx xxx xxxxxx'x xxxxxx xxxxxxxx, the total xxxxxx of xxx xxxx xxxxxxxx xxx xxx xxxxxx xx xxxxxxxxxxxx xxxx to xxx xxxxxx.

Xxxxxx xxx/xxxx/xxxxxx

Xxxxxxxxxxxxxxx xx, xx v xxxxxxxx, x ktorej xx xxxxxxxxxx, xxx xxxxxx Vás xxxxxxxxx xxxxxxxxxxxx xxxxxxxx. X xxxxxx xxxxxxxx xxxxxxxxx Xxxxx žiadosti x xxxxxxxxxxx xxxxxxxx xxxxxx xxxxxxx xxxxxxxx činnosti xxxľx xxxxxx č. 209/1997 Zb., xx xxxx xxxxxxxxx xxxxx xxxxxxxxx nevyhnutné. Xxxxxxxx Xxx za xxxxxxxxxx, ktorú xx xxxxx xxxxxx.

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X. Prosím, xxxxxxx xxxxxxľxx xxxxxx xxxxx x žiadateľovi - obeti xxxxxxxxx xxxx, ktorej xxôxxxxxx xxxx xx xxxxxx, xxxxx xxxxx xxxxxxxxxx xx osobe, ktorá x xôxxxxxx xxxxxxxxx xxxx zomrela:

1. Priezvisko:

2. Xxxx:

3. Dátum xxxxxxxxx:

4. Xxxxxx xxxxxxxx xxxxxx:

5. Xxxxxxxxxxxxxx adresa (v xxxxxxx, xx xx xxxx xx xxxxxx xxxxxxxx xxxxxxxx):

6. Telefón:

7. X-Xxxx:

8. Xxxxxxxxxx:

XX. Xx xxxxxxxľx xxxxxxxxx xxx xxxxx (zástupca) xx xxxxxxx xxxxxxxxx xxxxxxxxxx (xxxx. xxxxxxxx dieťa xxxxxx xxxxxxx) xxxxx xx xxxxxxx xxxxxx x xxxxx xxxx, xxxxxxx xxxxx o xxxxxxxxxx:

1. Xxxxxxxxxx:

2. Meno:

3. Xxxxxxxxxxxxxx xxxxxx:

Xx xxxxxxx xx xxx xxxxx, xxxx sa xxxxxxx xxxxxxxxxx, xxxxx xxxxxxxxxx xxxxxxx. Xxxxx x xxxxxxxx priložte xxxxx xxxxx xxxx (pri xxxxxxxx zastúpení) xxxxx xxxxx rodného xxxxx (x xxxxxxx zákonného xxxxxxxxxx) alebo inú xxxxxxx listinu.

III. Xx xxxxxxxľ xxxxx xxxxx xxxxxxxxx po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xxxxxxx, xxxxxx, aj xxxxx x xxxxxxx xxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx narodenia:

4. Xxxxx xxxxxx:

5. Xxxxxxxx xxxxxxxx:

7. Xxxxxxxxxx:

8. V xxxx xxxxxx xxxx zomretá xxxxx v xôxxxxxx xxxxxxxxx činu x xxxxx žiadateľa (otec, xxxxx, xxxxx xxxxxx x spoločnej xxxxxxxxxx):

Xx xx xxxxxxxľ xxxxxx xxxxxxxxxx po xxxxx, xxxxx v dôsledku xxxxxxxxx xxxx zomrela, x xxxxxxxx xx xxxx priložiť kópia xxxxxxxx listu x xxxxxxx, ktoré xxxxxxxxx xxxxxxxxxx, že umretá xxxxx vyživovala xxxxxxxxx xxxxx xxxxx mala xxxxxxxxx xx vyživovať (xx xxxxxx xxxxx - xxxxx xôxxx x xxxxx list xxxxx rozhodnutie xxxx x xxxxxxxxxxx xxxxxxxxxx, xxx xxxxxxxx xxxxx xxxxxxxx xxxx xxxxxxx xxxx x xxx.)

XX. Xxxxxx, či xxxxxxx xxxxxxxx peňažnú pomoc xxxxxxxxxxxxxxx pošty xxxxx xxxxxxxx xx xxxxxxx xxxx; v takom xxxxxxx xxxxxxx oznámte xxxxx Xxxxx xxxx.

X. Xxxxxx xxxxx, xxxx xx obeť dozvedela x škode xxôxxxxxxx xxxxxxxx xxxxx.

Xxxxxx xxxxx xxxxxxxxx trestného xxxx x ak xx xxxx x xxxxx xxx xxôxxxxxxx xxxxxxxxx xx neskôr, uveďte xxxx x xxx (xxxxxxxxx x lekárskej xxxxxx - xxxxx xxx xxxxxxxxxx).

XX. Xxxxxxx xxxxx xxxxx v xxxxxxxx xxxxxx (xxxxxxxxx xxxxx, štátne xxxxxxxxxxxxxx, xxx), ktorý naposledy xxxxx konanie o xxxxxxxx xxxx. Xxxxxx xx xxxxxxx xxxxxx, xxx ktorou xxxxxxxx xxxxxxxxxxxx.

Xx máte k xxxxxxxxxx posledné xxxxxxxxxxx xxxxxx xxxxxxx x xxxxxxxx xxxxxx, xxxxx xxxx predstavu x xxx, x xxxx xxxxxx xx xxx xxxxxxxx (xxxx. xxxxxxxxx x xxxxxxxx xxxxxxxxx xxxxxxxx, xxxx xxxxxxxx, xxxxxxxx - x xxxxxxxxxxxxx), xxxxxxxx ho x žiadosti.

VII. Xxxxxx, xxxx xxôxxxxx xxx xxxxxxxxx xxxxx na xxxxxxx xxxxx xx xxxxxxxľx alebo inej xxxxx, xxxxx zodpovedá xx škodu.

Podľa xxxxxxxxxxx §8 zákona x. 209/1997 (Xx)., xxxxxxxx xxxxx sa xôxx xxxxxx xxxxx xx xxxxxxxx x prihliadnutím xx to, či xxxx xxxxxxx xxxxxx xxxxxxx prostriedky xx xxxxxxxxxx nároku xx xxxxxxx xxxxx xx xxxxxxxľx alebo xxxx xxxxx, xxxxx zodpovedá xx škodu. Xxxxx xxx xxxxxxxxxxx, xx xxxxxxxľx xxxxxxxxx xxxx xxxxxxxxx.

Xxx XXXX. Xxxxxxx, xx xxxxxxxľ xx xxxxxxxxxx po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx činu xxxxxxx.

XXXX. Xxxxxx, xx xxx xxxxxxx osobou, ktorá xxľxx podmienky uvedené x §2 xxxx. 2 xxxxxx x. 209/1997 Xx., prípadne xxľxx xxôx xxľxx xxxxx xxxxxxxxx, xx xx Xxx xxxxx xxxxxxxxxxx xxxxx.

1. Xxxx xxx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx osoby, xxxxx zomrela v xôxxxxxx trestného xxxx?

2. Xxxx xxx x xxxxxx trestného xxxx xxxx xxxxxxxxx trestného xxxx x spoločnej xxxxxxxxxx?

3. Xxxxxxxxxxx Xxx xxxx trestného xxxx xxxxxx, či xxxx x xxxx povinná?

4. Xxľxxxx další osoby xxxxxxxxxxx xxxxxxxxx 1 xx 3? Xxxxxx xxx počet, ak Xxx xx xxxxx.

Xxxľx xxxxxxxxxxx §2 xxxx. 2 xxxxxx č. 209/1997 Xx. xx xx xxxx xxxxxxxx xxxxx xxxxxxxxx po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, ak xx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx zomretého x xxxxxxx x čase xxxx smrti x xxx xxxx v xxxxxxxxxx alebo osoba, xxxxxx xxxxxx poskytoval xxxxx xxx xxxxxxx xxxxxxxxxx výživu.

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Body XX. xx XXX. Xxxxxxx, xx xx xxxxxxxľ xxxx xxxxxx xxxxxxxxx xxxx a xxxx xx xxôxxxxxx xxxx xx xxxxxx.

XX. Xxxxxx xxxxx, xxxx xx xxxxxxxx xxxxxxxx, xxxxxxxxxx xxxx xx xxxxxxxx xxxxxxxx neschopnosť.

X. Xxxxxxx xxxxx bodového xxxxxxxxxxx xx xxxxxx činí:

K xxxxxxxx xx xxxx xxxxxxxx bodové xxxxxxxxxxx xx xxxxxx xxxľx xxxxxxxx č. 440/2001 Zb., ktoré xxxxxxxľ xxxxx xx xxxxxx, xxxxx xx xxxxxxxxx. Tento lekársky xxxxxxx xxxx xxxxxxxxx xxxxxx xxxxxxxxxx xxxxxxxxx xxxxxxx a bodové xxxxxxxxxx sťaženia xxxxxxxxxxxxx xxxxxxxxxx. Pripomíname, xx xxx xxxxx zákona č. 209/1997 Zb. je xxxxxxxxxx xxx xxxxxx ohodnotenie xxxxxxxxx xxxxxxx. Podľa xxxxxxxxxxx §6 odst. 2 xxxxxx x. 209/1997 Xx. xxxxxxx xxxxxxxxx' xxxxxxx xxxxx, xx xxxxxx ohodnotenie xxxxxxxxx xxxxxxx xxxxxxxxxx xxxxxxxx 100 bodov.

XI. Xxxxxx, či žiadate x xxxxxxxxxxx xxxxxxxx xxxxxx xx xxxxx xxxxxxxxx čiastky 25&xxxx;000.- Xx alebo či xxxxxxxx xxxxx ušlého xxxxxxx a xxxxxxxx xx xxxxxxxx.

Xxxľx xxxxxxxxxxx §7 xxxx. 1 xxxx. a) xxxxxx x. 209/1997 Xx. xx xxxxxxx obete xxxxx poskytnúť xxxxxxx xxxxx xx výške xxxxxxxxx sumy 25 000.- Xx, xxxxx vo xxxxx zodpovedajúcej preukázaným xxxxxxxx xx xxxxxxxx x xxxxxx xxxxxxx. Xx xx xxxxxxxxxx xxxxxx x xxxxxxx xxxxx xx výške xxxxxxxxx xxxxxxx, nemusíte xx xxxxxxxxx xxxx XXX. - XXX. xxxxx dotazníka.

XII. Xxxxxxx xxxxxxx x xxxxxxxx xxxxxx:

Xxx x xxxxxxx xx xxxxx, zdravotnícke xxxôxxx, xxxxxxx xx xxxxxxxxxxxxx, xxxxxxxxx xxxxxx xxxxx xx xxxxx x xxxxxxxxxx xx xxxxxxxxxx, xxxxxxx xxxxxxx xx xxxxxxx, x xxx. pod podmienkou, xx xxxxx xxxxxxx xxxxxxxxx pojsťovňa. Xx xxxxxxx xxxxxxx xx xxxxx xxxxxxx, xxxx xx xx xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxx mócť xxxx zreteľ.

XIII. Xxxxxxx xxxxxxxxx xxxxxx xxxxxxxľx xxxx a xx xxxxxx xxxx xx xxxxxx spôsobenej xxxxxxxx xxxxx.

X xxxxxxxx xxxxxxxx xxxxxxx, ktoré potvrdzujú xxxxxxx xxxxxxxxxxx.

X xxxxxxx, xx xxxxxxxľ xx x zamestnaneckom pomere, xôxxx x potvrdenie xxxxxxxxxxxxľx x priemernom xxxxxxx xxxľx §351 x xxxx. xxxxxx x. 262/2006 Xx., xxxxxxxx práce, x xxxxx neskorších xxxxxxxxx. Xx xx xxxxxxxľ xxxxxx samostatne xxxxxxxxx xxxxxx, xxxxx listinou xxxx xxxxxxxxx xxxx xxxxxxxxxx xxxxxxxx xxxxxxxxx. Xx xxxxxxxľ xxxxxx xxxxxxxx dôchodok, dokladom, xxxxx xôxx xxxxxxx xxxxxxxx sociálnu situáciu, xxxx xxxxxxxxxx o xxxxx xxxxxxxxxx xôxxxxxx. X prípade, že x xxxxxxxx xxxxxxxxx xôxxxx xxxxxxx doložiť xxxxxxxxx xxxxxx xxxxxxxľx, x krajnom xxxxxxx xx xxxxx xxxxxxxx xxxxxxxxxx x xxxx xxxxxxx xxxxxxxxxx.

XXX. Xxxxxx xxxxx xxxxxxxxxxxx xxxxx (xxxxxxxxxxx dôchodku) a xxxx, xxxxxx xxx xxxxxxxľ xxxxxx, xx xxxxxxx xx xxxxxx xxxx xx zdraví, xxôxxxxxxx trestným xxxxx.

X xxxxxxxx xxxxxxxx xxxxxxxxxx xxxxxxxxxxxxľx xxxxx xxxxxxxxx x výške xxxxxxxxxxxx xxxxx. X xxxxxxx, xx x xôxxxxxx xxxxx xx zdraví xxôxxxxxxx trestným xxxxx Xxx xxxxxxxx invalidný xôxxxxxx, xxxxxx x xxxxxxx xxxx xxxxx.

Xxxx majetkové pomery xx xxxx, že xxxxxxxx xxxxx, xxxxxxx xxx xxx(x) xxxxxx, xx moja xxxxxxxx xxxxxxxx xxxxxxxx. Xxxxx, xxxxx mi xxxxx xxôxxxxx, xxxxxľ xxxxxx xxxxxxxx.

Xxxxxx vyhlasujem, xx xxxxx xx peňažnú xxxxx či obdobný xxxxx xx xxxxxxxxxxx xxxx spôsobenej trestným xxxxx som neuplatnil(a) x žiadnom inom xxxxx xxx v Xxxxxx (Xxxxxxxxxx) xxxxxxxxx.

Xxxxxx xx xxxxxxx, xx xx podľa xxx. §12 xxxxxx x. 209/1997 Xx., x xxxxxxxxxx xxxxxxxx xxxxxx xxxxxxx xxxxxxxx xxxxxxxx x x xxxxx x o xxxxxxxx xxxxxxxxxx zákonov, v xxxxx xxxxxxxxxx xxxxxxxxx, xxxxxx povinnosť xx xxxxxxx xxxxx xxx xxx, xxx xx xxxxxxxx pomoc, xxxxxxx xx xxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxx, xxxxx xxx dostal(a) xxx xxxxxxx škody, x xx až xx xxxxx xxxxxxxxxxx xxxxxx. Xxxxxxx s tým xxxxxx xx xxxxxxx, xx xx uplynutí xxxxxxxxxx xäxxxxxxx xxxx xôxxx xxxxxxxx Xxxxxxxxxxxx xxxxxxxxxxxxxx, xxx xx x mene štátu xxxxxx xxxxx na xxxxxxxx poskytnutej xxxxxx, xx xxxx sociálna xxxxxxxx bude taký xxxxxx xxôxxxxxxxx, xxxxxxx xxxxx xxxxx, xxxxx xx xxôxxxxxx a xxxxx xxxxxxx, ktorú xxx dostal(a).

Beriem xxxx xx vedomie, xx xxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxx xxxxxxxxx údaja xx xxxx xxxxxxxxx xx účelom získania xxxxxxxxxxxx xxxxxx, sa xôxxx xxxxxxxx xxxxxxxxxx xxxľx §21 xxxx. 1 xxxx. c) xxxxxx x. 200/1990 Xx., x xxxxxxxxxxxx, x xxxxx neskorších xxxxxxxxx.

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xxxxxx xxxxxxxľx xxxxx xxxxxxxx

- Xxxxxxxxxxxx xxxxxxxxxxxxxx Xxxxx republiky xx xxxxxxx žiadosti o xxxxxxxxxxx xxxxxxxx xxxxxx xxxľx zákona č. 209/1997 Zb. xxxxxxx xxx príjem x udelí xxxxxxxx xxxxx. Xxxxx bude xxxxxxxxxx xx xxxxxxx xx xx xxxx xxxxxxxx orgáne xxxľx xxxxxxxxxxx okolností prípadu. Xx troch mesiacov xx xxxxxx žiadosti x xxxxxxxxxx xxxxxxxxxx xxxxxxxx xxx xxxxx xxxxxxxx xxxxx žiadateľovi xxxxxx dôvody, xxxxx xxxxx nemožno xxxxxxxx.

- X zmysle xxxxxx č. 209/1997 Zb. xxxx xxxxxxxľ xxxxxxxxxx za obeť xxx x prípade, xx xx x xôxxxxxx trestného xxxx xxxx spôsobené poškodenie xxxxxxx. Xxxxxxxxxxx, xxx xxxx postačujúcou xxxxxxxxxx xx priznanie xxxxxxxx xxxxxx takej xxxxx xx xxxxx xxxxxxxx xxxxxxxxxxx xxxxxxx (xxx xxxx xxxxxxxx xxxxxxxxxxxxx xxxxxxxxxx) xxxxxxxxxxxx xxxxx 100 xxxxx. Xx xxxx xx považuje xx xxxxx xxxxxxxxx xx xxxxx, xxxxx x xôxxxxxx trestného xxxx xxxxxxx, ak xxxx xxxxxxx, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx x xxxxxxx x xxxx xxxx xxxxx x xxx žila x domácnosti, xxxxx xxxxx, xxxxxx zomretý xxxxxxxxxx xxxxx xxx xxxxxxx xxxxxxxxxx xxxxxx.

- Xxxxx č. 209/1997 Zb. o xxxxxxxxxx xxxxxxxxx xxxxxx xxxxxxx trestnej xxxxxxxx xxxxxxxxx xxxxxxxxxxx (prepadnú) xxxx 1 xxxx xxx dňa, xxx xx xxxx xxxxxxxxx x xxxxx spôsobenej xxxxxxxx xxxxx. Ak xxxxx xxxx už xxx xx xxx xxxxxxxxx xxxxxxxxx činu, xxxx dokazuje xxxxxxx, xxxx xx to xxxxx. Xxxxxxxxxxxx xxxxxxxxxxxxxx xxxôxx vyhovieť xxxxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx, xxxxx xx xxxxxxxx xx xxxxxxxx xxxxxxxxxx lehoty.

- Pomoc xx xx xxxxxxx xxxxx, xxxxxx v xôxxxxxx xxxxxxxxx xxxx xxxxxxx xxxxx xx xxxxxx, poskytne x xxxxxxxxx sume 25&xxxx;000.- Xx xxxxx xx xxxxx, xxxxx predstavuje xxxxxxxxxx xxxxxx na xxxxxxx, preukázané xxxxxxx xxxxxxx s xxxxxxxx, xxxxxxx x súčet xxxxxxxx xxxxxxx, xxxxx xxxx x xxxxxx xxxxxxx škody xx xxxxxxx; pomoc xx xxxxxx xxxxx nesmie xxxxxxxxxx xxxx 150 000.- Xx. Ak xxxx - xx tom, xxx xxx poskytli xxxxx - xxxxxxxx, xx xxx vzniknutá xxxxx xx xxxxxx xxx xx, xxxxx xxxx podkladom xx xxxxxxxxxxx xxxxxx, xx xxx žiadosť v xxxxxx xxxxxxxxxx xxxxx xxxxxxx xxx možno xxxxxxxxx pomoc xxäx, x to xx xx xxxxxxxxxx xxxxx 150&xxxx;000.- Xx; pričom xx xxxxxxxxxx xx xxxxxxx, xxxxx už xxxx xxxxxxxxx.

- Xxxxxxxx xxxxx, ktorá je xxxxxxxxxx xx xxxxx, xxxxx v xôxxxxxx xxxxxxxxx xxxx zomrela (xx xxxx rodičom, xxxxxxxx xxxxx dieťaťom xxxxxxxxx a xxxxxxx x xxxx jeho xxxxx s ním xxxx x domácnosti, xxxxx xxx xxxxxxx xxxxxxxxxx, xx bol xxxxxxx poskytovať výživu), xx poskytne peňažná xxxxx v xxxxxxxxx xxxx 150&xxxx;000.- Kč; xxxxx xx xxxxxx xxxxx nesmie xxxxxxxxxx xxxx 450&xxxx;000.- Kč, x xx je xxxxx xxxxx xxxx xxx xxx xxxxx, xxxxxxxxxxx xxxxxxx xx xxx xxxxxx xxxxx xxxxxxxxx kráti.

- Zákon č. 209/1997 Zb. xxxxxxxxxxxx xxxxxxxx xxxxxxxxxxx zodpovednosti xxxxxxxxxxľx xxxxxxxxxx xxxxxxxx, na xxxxx nadväzuje xxxxxxx xxxxxxx poistenie xxxxxxxxxxxxx. Xxxxx je potrebné x xxxxxxxxxxxxxx dopravných xxxôx xxxxxx subjekt, xxxxx xxxxxxxx poistenie xxxxxxxxxxxxx, x poskytnutie xxxxxxxxx xxxxxxx. Xxx x celkom xxxxxxxxxxx xxxxxxxxx x prihliadnutím xx xxxxxxxxx xxxxxxxxx xxxxxxxxx xx xxxxx xxxxxx xxxxxxxxxxxx xxxxxxxxxxxxxx x xxxxxxxxxxx peňažnej xxxxxx.

- Xxxxxxxxxxx, xx xx xxxxxxxxxx xxxxxxxx xxxxxx xxxxxxxx xxxxxxx x potvrdenia, xx xxxxx odkazujeme xxx xxxxxxxxxxxx položkách. Xx xxx xxxxxxxľ neučiní, xxxxxxxxxxxx xxxxxxxxxxxxxx xxxôxx xxxxxxx xxxxxxx. Xx xxxxxx potvrdenia x xxxxxxx ani dodatočne xxxxxx, táto xxxxxxxxxx xôxx byť xôxxxxx xxxxxxxxxxxxx peňažnej xxxxxx xxxľx xxxxxx č. 209/1997 Zb. Xx však nevylučuje xxxxxxx xxxxx xxxx xxxxxxx.

- Upozorňujeme, xx xx bude xxxxxxxľxxx xxxxxxxxxx xxxxxxx xxxxx, xxxxxxxľ je do xxxxxxx xxxxx odo xxx xxxxxxxxxxx pomoci xxxxxxx na xxxx xxxxxxxxxxxx xxxxxxxxxxxxxx sumy, xxxxx dostal xxx xxxxxxx škody (xx xxxxxxxľx, xxxxxxxxx x xxx.) až xx xxxxx poskytnutej xxxxxx. Xxxx povinnosť xxxx, xx mu xxxxx xxxxxxxxxx. Na základe xxxxxxxx xxxxx sa xxxxxxxxxxxx xxxxxxxxxxxxxx xôxx x xxxx xxxxx xx xxxxxxxx stanovenej xäxxxxxxx xxxx xxxxx xxxxx xx xxxxxxxx xxxxxxxxxxx xxxxxxxx xxxxxx. Xx xxxxxx postup xxôxxxxxxx xxxxxxxx situácia xxxxx, xxxxxxx xxxxx xxxxx, ktorú jej xxôxxxxxx, a xxxxx xxxxxxx, xxxxx obeť xxxxxxx.